Probiotics for colitis – do they work?

Over the last several months I’ve written many blogs about “good” bacteria as a potential treatment for colitis. While lesser-known probiotics such as F. prausnitzii have been shown to decrease intestinal inflammation and disease activity, other more common probiotics such as Lactobacillus and Bifidobacterium may also reduce disease severity.

Various clinical studies have compared whether probiotics can improve patients’ disease activity compared to no treatment or compared to conventional therapy with 5-ASA (Asacol, Pentasa, Lialda). Some probiotics like Lactobacillus GG or E. coli Nissle (a mutated probiotic strain of E. coli) were shown to reduce disease to a similar level as 5-ASA. Other probiotic mixtures such as VSL#3 and Yakult, which contain several strains of Lactobacillus and Bifidobacterium mixed together, were found to reduce symptoms compared to placebo or in some cases had a better outcome than 5-ASA treatment alone.

Interestingly, studies looking at the clinical efficacy of several probiotic regimens have shown improvement in disease symptoms only in colitis patients, and not in those with Crohn’s. This may be due to the fact that the colon has a significantly larger bacteria population compared to the small intestine. Many of the probiotic studies in Crohn’s patients did not indicate if the patients had ileal disease or Crohn’s colitis.

These findings are promising, but more studies need to be done to determine whether probiotics could replace existing colitis treatments or perhaps help them to work better. Although probiotics are fairly safe, there are also a few rare negative effects associated with probiotics, including bacteremia or bacterial infections of the blood.

All in all, if you like yogurt or can drink milk, you might want to try the kinds that contain probiotic bacteria and see if they help your symptoms. There are also a few clinical trials around the country involving probiotic therapy and IBD.